When my wife became pregnant for the first time, we would joke that it was going to be twins. She would tell me, “one baby for you and one for me.” Of course we didn’t really expect that she was pregnant with twins. Then we went in for the 20 week ultrasound to find out the sex of our baby. The technician said, “You already know you are having twins right?” Needless to say, we were shocked!

If we had known about the signs of a twin pregnancy at the time, we might have joked a little less and prepared a little more.

The ultrasound

A picture is worth a thousand words and if you are pregnant with twins, maybe two thousand! If there is one sure fire way to know that you are pregnant with multiples, it’s with an ultrasound. The catch with ultrasounds is that most pregnant women don’t get one until around week 20.  Of course if you used fertility drugs or treatments, you will most likely receive an ultrasound much sooner.

An ultrasound done at 5 to 7 weeks would most likely determine if you are carrying twins, but there usually has to be some reason for an early ultrasound. So should you request an ultrasound based on a hunch that you might be carrying multiples? Maybe you should, but there are also some other early indicators to consider.

“Triple Test” results

As an expecting mother, you will usually undergo what is referred to as “the Triple Test”, “Multiple Marker Screening” or “AFP Plus test” at about 13 weeks from conception. This test checks the levels of certain proteins (AFP, HCG and UE3) in your blood. Based on these levels, your age and ethnicity the test will indicate the probability that your fetus may have certain genetic disorders.

The original purpose of “the Triple Test” was to screen for Down syndrome, open neural tube defects and ventral wall defects. However, over the years it has been refined to the point where it can indicate the presence of twins about 50% of the time.

Two heart beats

Most doctors will use a fetal Doppler (think speaker box held to your belly) to monitor and let your hear the baby’s heartbeat. A Doppler can usually detect a heartbeat(s) between 8-12 weeks. If two heartbeats are detected, there is a good chance that it is because there are two babies!

One thing to keep in mind, especially if you are using a Doppler on your own is that it is very easy to hear a singleton’s heart beat from different locations. If the heart rates are close together (within 10 beats per minute or so), it is most likely coming from one baby. If the heartbeats are coming from two different locations and are different rates, this would be a good time to consider an ultrasound. It is important to note that the mother’s heartbeat can sometimes be mistaken for a second baby as well.

Morning sickness to the max

Unusually excessive amounts of morning sickness are sometimes reported by mothers of twins. Even so, this is a very subjective indicator of a multiple pregnancy. Only about half of all expecting mothers (multiples or otherwise) experience morning sickness.

Increases in your size and weight

During your pregnancy, your doctor will likely take various measurements and compare them with averages to track your progress. Excessive weight gain could be a sign that you are carrying multiples. This is fairly hard to determine however, because weight gain is a normal part of any pregnancy. In fact, on average a mother of twins only gains about 10 lbs. more than a mother of singletons during her pregnancy.

In addition to your weight, your doctor will likely measure your belly (uterine fundus if you want to get technical) and track it as it gets bigger. If these measurements are greater than the average, it could be a sign of multiples.

It feels like there is an octopus inside me

Some mothers who have given birth to both twins and singletons have said that they were able to detect fetal movement earlier with their twins. While this may be the case in some pregnancies, it is certainly not a scientific fact.

Mother’s intuition

Many mothers of twins (including members of this site) have said that they just “knew” that they were pregnant with twins. This can be likened to mothers who just had a “feeling” that they were going to have a boy or a girl. While a mother’s intuition is very far from a medical indicator, we aren’t willing to rule it out completely.

Other factors

Here are some other factors that could lead to an increased chance of having a multiple pregnancy:

  • Age – As you age, your chance of having twins increases.
  • Weight – If you are overweight, you have a greater chance of having twins.
  • Family history – Having a family history of twins can increase the chances.
  • Having many children – If you already have many children, then your chances of having twins increases.
  • Previous multiple pregnancy – If you have already had a set of fraternal twins, your chances of having twins again is increased by by four!
  • Fertility drugs/treatment
  • Getting pregnant while breastfeeding – Some studies have shown that your chance of conceiving multiples rises if you are breastfeeding.
  • Getting pregnant while on “the pill”

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